Adv Tembeka Ngcukaitobi to probe claims of racism by medical schemes

ToxicBunny

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My thoughts as well.

Discovery (and all other Medical Schemes) actually need to stand up and tell the SAHRC to go fsck themselves... tell them to have their inquiry, then drown them in legal crap and just make them cry in the corner like the wastes of space they have become.
 

ponder

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My thoughts as well.

Discovery (and all other Medical Schemes) actually need to stand up and tell the SAHRC to go fsck themselves... tell them to have their inquiry, then drown them in legal crap and just make them cry in the corner like the wastes of space they have become.
Boogles the mind, they want them to racially profile the practitioners and I bet you the second they do the sahrc will scream racism. Take them to court I say.
 

ToxicBunny

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Boogles the mind, they want them to racially profile the practitioners and I bet you the second they do the sahrc will scream racism. Take them to court I say.
Yeah I'm leaning in that direction..

Someone needs to quite literally give the SAHRC a legal beat down to the point that they shut up....
 

Nirv

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So let me get this right. Doctors are claiming racism from medical aids, there's now an investigation, and then it turns out they don't keep any data on any immutable characteristics of medical practitioners. Then, instead of turning around and congratulating them on their upholding of the non-discriminatory practices that our Constitution requires, they have issues with... Not... Being racist/sexist?!
 

ponder

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So let me get this right. Doctors are claiming racism from medical aids, there's now an investigation, and then it turns out they don't keep any data on any immutable characteristics of medical practitioners. Then, instead of turning around and congratulating them on their upholding of the non-discriminatory practices that our Constitution requires, they have issues with... Not... Being racist/sexist?!
Yip pretty much that.
 

ToxicBunny

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So let me get this right. Doctors are claiming racism from medical aids, there's now an investigation, and then it turns out they don't keep any data on any immutable characteristics of medical practitioners. Then, instead of turning around and congratulating them on their upholding of the non-discriminatory practices that our Constitution requires, they have issues with... Not... Being racist/sexist?!
100%...

And the SAHRC are upset because well they have nothing to complain about, so they will invent this historical context BS that seems to be their new go-to.
 
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Gordon_R

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Whatever your feelings about medical aids, it is clear that some medical practitioners are cheating, and playing the race card when they are being investigated: https://www.dailymaverick.co.za/article/2019-07-04-medical-aid-schemes-caught-in-a-vice-between-fraud-and-claims-of-racial-profiling/
SA’s largest medical aid scheme, Discovery, for example, investigates about 3,500 potential fraud cases a year, and 82% of them turn out to be valid, according to documents provided by the scheme.
But the problem for Gumede and the NHCPA is that correlation is not causation; just because the majority of victims of medical aid banning orders are black doesn’t necessarily mean they are being targeted on a racial basis.

But it does, obviously and sadly, say something about the skewed nature of South African society – and perhaps also the tendency to see problems that are essentially social in nature through a racial lens.
 
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schumi

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Council probes alleged racism by medical aid schemes

Black and Indian doctors told the inquiry of bullying and non-payment by the schemes, which led to several of their colleagues taking their own lives.


Black and Indian doctors have detailed under oath how they were bullied by medical aid schemes who queried their claims and refused to pay, leading to some taking their own lives or losing their practices and homes.

The practitioners told the first day of the Council for Medical Aid Schemes’ hearings into allegations of racial profiling against black and Indian private medical practitioners yesterday that they were targeted for perceived fraud, incorrect billing and excessive prices to block their payments.

At the heart of their submission was that medical aid schemes demanded proof of consultation, including clinical notes, while their white counterparts were simply required to “verify” a consultation before payments were made.

Dr Hlengiwe Zwane, a clinical psychologist, testified that she was blocked by a medical aid scheme and her patients referred elsewhere when she refused to be “bullied” into breaching her sacrosanct “doctor-to-patient confidentiality” to release her patients’ clinical notes as proof of consultation.

.
More at : https://citizen.co.za/news/south-africa/investigation/2160947/council-probes-alleged-racism-by-medical-aid-schemes/
 
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diapason

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Problem with Discovery is paying the member if the healthcare professional charges over the medical aid rates, irrespective if the patient has paid the claim or not. I guess many members are pocketing the money and not paying over to the healthcare professional.
That's not a Discovery issue. That is a legislative issue. Legislation needs to be changed in order to allow part payments to medical professionals. That way they are not totally out of pocket by virtue of members misusing their refunds.
 

schumi

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Medical aid inquiry told GPs earned smallest share in funds collected by schemes

CENTURION - The National Health Care Professionals Association (NHCPA) said medical aid schemes were becoming cash cows at the expense of general practitioners (GPs) who were at the centre of the profession.
On Wednesday, the association presented to the Section 59 inquiry into allegations of racial profiling by medical schemes.
It told Advocate Tembeka Ngcukaitobi and his panel that schemes were becoming prosecutors and judges in their own cases when they decided to blacklist professionals.
NHCPA chair Dr Donald Gumede said GPs earned the smallest share of the medical aid funding collected by schemes.
“Thirty-five percent of the money goes to administrators, 40% to hospitals which are partly owned by medical schemes, 20% goes to specialists, such as pharmacists, and 5% went to GPs who are actually at the heart of mistreatments.”
More at: https://ewn.co.za/2019/07/31/medical-aid-inquiry-told-gps-earned-smallest-share-in-funds-collected-by-schemes
 

schumi

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SAMA calls for medical aid benefits model be overhauled

CENTURION - The South African Medical Association (SAMA) recommended that Section 59 inquiry investigating racial profiling should overhaul the benefits model of medical schemes in the country.
The association made representations at the inquiry in Centurion on Thursday.
Dr Norman Mabasa said because of that model, hospitals and specialists only wanted to attend to patients with limitless funds.
SAMA said it didn’t make sense that medical schemes wanted to investigate general practitioners for fraud when they only earned R6 billion annually compared to specialists who earned more than R20 billion.
More at: https://ewn.co.za/2019/08/01/sama-calls-for-medical-aid-benefits-model-be-overhauled
 

schumi

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IPAF grilled on disclosure of doctors' info to medical schemes

JOHANNESBURG- The Independent Practitioners Association Foundation (IPAF) faced difficult questions about its role in alleged racial profiling by medical schemes.
The organisation, which also works with the schemes, said it helped doctors with peer reviews to make sure that they were compliant.
But this prompted inquiry chair Advocate Tembeka Ngcukaitobi to probe how far the foundation went to disclose information about doctors to medical schemes.
The inquiry was looking into alleged racial profiling by medical schemes.
More at: https://ewn.co.za/2019/08/02/ipaf-grilled-on-disclosure-of-doctors-info-to-medical-aid-schemes
 

schumi

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Medical aid race scandal: Inquiry hears about 'focused investigation on Africans'

Johannesburg - An African pharmacist and a white physician have revealed contrasting experiences before the inquiry investigating whether medical schemes discriminated against black doctors.

Testifying at the Advocate Tembeka Ngcukaitobi-chaired inquiry on Monday, Adri Kok said there was no indication that schemes engaged in racial profiling before instituting investigations into physicians who are members of the South African Private Practitioners Forum (SAPPF). Kok is a director of SAPPF.

But her black counterpart, Kgabo Komape said evidence strongly indicated racial bias on probes against members of his organisation, the Independent Community Pharmacy Association (ICPA).

Komape effectively supported most of the testimonies that the commission has heard.

Black doctors have told the inquiry of how medical schemes launched "spurious" investigations into their practices when it was time to pay up.



They said medical schemes arbitrarily withheld money due to them when they launched their probes.

But Kok said it was uncommon for members of the SAPPF under investigation to have their money stopped.

“As far as I know, not any of the physicians have had their payments stopped,” said Kok. “No one has had their payments suspended.

“They would not stop payment until there’s complete non-compliance from the doctors side or there’s no response to letters.”

Doctors have nothing to be afraid of if they do the right thing, Kok said. “We’ve tried to ensure that our members understand that it’s absolutely crucial if you feel that you’ve done correctly, you must be able to defend that. I don’t think there should be an issue with that.”

She said their data on members that have been probed since 2016 does not show race bias.

Pressing Kok on her own data, Ngcukaitobi asked if it did not indicate bias against black doctors.

“So you’ve got 35 African doctors, and six are investigated. There are 148 white doctors and only seven are subject to an investigation.

“That number looks surprising because it seems to suggest that there is a focused investigation on Africans compared to whites," Ngcukaitobi put it to Kok.
More at:
 
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schumi

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Medical aid race scandal: Inquiry hears of spy tactics

Johannesburg - The inquiry into the allegations that medical schemes racially profiled black doctors has heard how Discovery Medical Aid recently entrapped a doctor into issuing fraudulent sick notes and then investigated him.

Discovery also tricked two other doctors into submitting fraudulent bills, Yvonne Naidoo, a lawyer from Elsabé Klinck & Associates said at the inquiry on Wednesday.

The scheme then turned around to inform the doctors that it had launched forensic investigations into their practices and withheld all money due to them, Naidoo said.

The doctors, who are all black, were then informed that in order to make their troubles go away they should enter into acknowledgement of debt agreements with the scheme.

The inquiry chaired by advocate Tembeka Ngcukaitobi has previously heard anecdotes about alleged unethical conduct of schemes when probing doctors it accused of fraud.
The probes have been described as a bullying tactic intended to embarrass doctors into paying medical schemes over "concocted" debts. Naidoo, from a firm that often represented doctors in their disputes with schemes, offered some of the traceable examples of the alleged unethical conduct by schemes.
Medical schemes will testify late next month, where they are expected to defend themselves.
The doctor entrapped to issue a fake sick note, according to Naidoo, was sent a letter inviting him to a meeting to discuss the alleged breach.
"By the time the client received this letter his claims were already suspended," said Naidoo.
"The client wasn’t informed but he could pick up from the claims that he submitted that he wasn’t getting paid.
More at:
 

ɹǝuuᴉM

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The racist ngcukaitobi will see racism everywhere.
Reminds me of some forumites. On the other hand, if the allegations are indeed true, hefty fines should be imposed. By now even the AWB should understand that.
 

ɹǝuuᴉM

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So let me get this right. Doctors are claiming racism from medical aids, there's now an investigation, and then it turns out they don't keep any data on any immutable characteristics of medical practitioners. Then, instead of turning around and congratulating them on their upholding of the non-discriminatory practices that our Constitution requires, they have issues with... Not... Being racist/sexist?!
Dammed if you do, dammed if you don't. South Africa 2019.
 

ToxicBunny

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Medical aid race scandal: Inquiry hears of spy tactics



More at:
So now, the doctors are unhappy because Discovery (and other medical aids probably) send in under cover people to get evidence of the doctor doing illegal things, and this is entrapment?!
 

Mista_Mobsta

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Funny that there is racially based narrative pushed against medical aids whilst the groundwork is laid out for the NHI???

Not coincidental at all right?
 
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